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Second of a seriesMANCHESTER — When the Valley Street Jail medical team refused to dispense doctor-prescribed medications for an inmate, her husband took Hillsborough County to court.

The result: the woman ended up with a $27,500 settlement, and the jail's long-term medical director ended up out of a job.

Dr. Charles L. Ward said recently that he was fired from his contracted position, which he held for about eight years, because of the lawsuit brought by Laurie Boilard.

Some people, he complained, will get physicians to prescribe powerful drugs before they enter jail for their sentence. "I'm caught between two forces," he said. "I can't practice good medicine and give an alcoholic sedatives."

Several lawsuits filed over the past six years take issue with medical decisions made at the jail under Ward and nurses, who play a significant role in running the jail's health care.

The suits and accompanying documents depict jail officials as indifferent to inmates' medical problems and always on-guard against drug abuse.

"Their collective attitude at (Hillsborough County Department of Corrections) was that inmates were manipulative and drug-seeking, not that they were very sick or had a potential life-threatening condition, requiring further care and evaluation," wrote Jacqueline Moore, a consultant hired by lawyers who collected $415,000 from the county after a heroin addict died when his symptoms went untreated.

Despite the Boilard suit, jail Superintendent David Dionne said the jail's medical department still decides an inmate's medications on a case-by-case basis. Some inmates find physicians who will readily prescribe them pharmaceuticals before they start their sentence at the jail, Dionne said.

He said he can't have 550 doctors making decisions for inmates under his care and custody.

"You're dealing with a different type of person when you're talking about correctional facilities or prisons," Dionne said.

Boilard entered the jail on July 29, 2008. Her lawyer had given the jail's medical department a list of six prescriptions she needed for her mental health illnesses. He warned the jail that she needed the meds to prevent a relapse.

Nine days later, the jail's medical team put Boilard on Prozac, which was not one of the six and which gave her adverse side effects, her suit said. She filed grievances; they went nowhere.

Offering to pay for Boilard's medication, her husband wrote the superintendent. He received curt replies saying his wife had been seen by the jail physician. He then filed a lawsuit in U.S. District Court. After nearly three months of fighting, Boilard got her meds.

In her review of the system, consultant Moore wrote that former jail superintendent James O'Mara had delegated the supervision of Dr. Ward to a licensed practical nurse, Denise Ryan, the health services administrator for the jail.

"Nurse Ryan was in no position to assess the clinical skills of Dr. Ward," Moore wrote.

Ryan would also make decisions on which inmates would have to be transferred to the hospital, Moore wrote.

Ward said Ryan, who has been with Hillsborough County since 2008 and earns $65,000, is very good at what she does.

He said Ryan has taken all the coursework for a registered nurse license. But as a full-time administrator and mother with children at home, she has been unable to pass her licensing exams, he said.

"As far as I'm concerned, she knows what she's doing," he said.

Dionne said the system is now changed; both he and Ryan oversee the work of the current jail medical director, Dr. Matthew Masweic. But Dionne stresses that he does not tell the physician what medication to prescribe or medical care to give.

Ward said he never felt budget pressures as jail physician, and the two hospitals in Manchester provided good care when he had to ship inmates out. He said most inmates are young and in good physical shape.

The settlement in Boilard's case was split between the county's insurer and the New Hampshire Medical Malpractice Joint Underwriting fund.

In another case, Raymond Rheault received $20,000 after complaining his medicine was eliminated and he was placed in solitary confinement for nine months, where his condition deteriorated so much that he had to be admitted to the New Hampshire State Hospital.Coming Tuesday: A female corrections officer speaks up; lawsuits generated by "The Hole."